Some of the disclosed embodiments relate to methods and apparatus for managing data relating to potentially changing conditions of multiple subjects. Some of these embodiments are disclosed in the context of managing data relating to separate individuals, and in some cases a large number of individuals involved in government supported social programs. However, embodiments are intended to cover or otherwise apply the disclosed methods and apparatus of data management in any other beneficial context, including data relating to individuals involved in other activities or programs, or even data relating to groupings of any number of things that are subject to any type of potentially changing conditions.
The tracking of changing conditions of individuals involved in government controlled social programs often involves the management of a tremendous amount of data. For example, in the United States, Head Start (HS) and Community Action Program (CAP) constitute two programs that affect or otherwise involve a large number of separate individuals. Both of these programs are discussed in more detail below for the purpose of providing context to the task of data management.
I. Overview of HS and CAP
Both HS and CAP are funded by the U.S. Department of Health and Human Services, and eligibility for aid from these programs is based on the federal poverty guidelines, i.e., family income, number of family members, etc. HS focuses solely on children, while CAP focuses on families, such as to provide money for food, energy, food stamps, etc. Each of these programs is discussed below.
HS targets low income people, and is organized and formed within: 1) school districts, 2) city governments, 3) county governments, 4) non-profit organizations, i.e., catholic charities, etc. Most HS organizations are urban, but there are also a number located in rural areas. Most HS organizations are independently formed non-profit organizations for the sole purpose of pursuing HS.
HS only covers pre-school (birth to 5 years old), and after that the children attend public school. Some benefits of HS are based on studies showing that people are ultimately more successful if they attend pre-school. Early HS (started in the mid-1990s) covers children from birth to 3 years old, and traditional HS (started in 1964) covers children 3-5 years old.
HS was initiated in 1964 as part of President Johnson's war on poverty. It began as a summer camp, and originally solely involved teaching children to read and write. However, HS currently involves many more subjects, and is a comprehensive child development program, covering language and literacy; cognition and general knowledge; physical development and health; social and emotional development; and approaches to learning. A significant HS goal is to break the cycle of poverty.
Family interviews can also be held to assess conditions at the home. HS has developed procedures to help build a better family environment, i.e., assess the family's needs, their strengths, etc., and prepares a family partnership agreement (FPA). This procedure thereby helps to provide a comprehensive child development plan. The program is designed to first determine the family's needs (needs assessment), and then works with the family as a partner to provide a nurturing environment for the child.
HS especially focuses on outcomes, i.e., how well the program is working. HS's outcome focused methodology is at least partially responsible for it becoming the most successful social services program, and is supported by both Democrats and Republicans in the U.S.
In order to form a HS organization, a proposal needs to be submitted to the federal government, which includes a plan of how to recruit families (i.e., children). Most HS organizations are formed for the sole purpose of promoting HS. Once formed, the federal government provides money to fund the HS organization, which constitutes a large majority of the operating budget, and attending (participating in) HS is free.
There are approximately 2000-3000 separate HS organizations (grantees and delegates) currently operating in the United States. A typical HS organization serves 100-500 families (children). There are typically 15-17 children per classroom, and 10-20 classrooms per HS organization. Each classroom has one teacher and one assistant teacher. A family advocate also works with the teachers, but from a different perspective, i.e., the advocate monitors the children's health and the family environment. Each advocate covers 1-2 classrooms, and visits the homes 1-2 times per year.
A typical HS organization begins as a grantee, and there are approximately 1600 grantee organizations currently operating in the United States. However, a HS organization may also be formed as a delegate agency that tags-on to an existing grantee's proposal, and there are approximately 3000 delegate agencies currently operating in the United States. Each delegate agency is separate from its corresponding grantee. For example, New York City's government is a grantee, with 100-200 separate associated delegate agencies throughout the city. The grantee receives federal grants to cover (fund) the associated delegate agencies. A mandatory on-site review is required every three years.
Each grantee or delegate agency receives approximately $1M-$3M a year in funding, and thus the entire HS program (covering the entire United States) receives approximately $9B-$10B in funding per year. Approximately 80% of the funding is provided by the federal government, and the remainder (approximately 20%) is provided by private local sources, i.e., private sponsors and in-kind donations.
The United States includes a few hundred CAP organizations. CAP only focuses on the family, and includes the following programs: 1) Weatherization Program—seals doors, windows, etc., such as to prevent cold air from entering the home in winter; 2) Energy Program—pays the electric bill; and 3) Food Pantry Program—provides food.
FIG. 1 is a schematic of a typical structure of a HS/CAP organization. As shown in FIG. 1, a CAP Director 103 and HS Director 105 both report to an Executive Director 101. The CAP Director 103 manages a Weatherization Program Director 107, Energy Program Director 109, and Food Pantry Program Director 111. The HS Director manages the Center Directors 113 (represented as Centers 1 through n), as well as a Content Manager 115. HS Managers include any positions that manage family data of their caseloads or classrooms 117, including Directors, Family Advocates 119, Home Visitors, Teachers 121, and Teachers' Assistants 123.
The following Directors report to the Content Manager: Mental Health Director (Psychologist) 125; Director of Physical Health (Nurse) 127; and Disabilities Director (Nurse who checks hearing, vision, and learning issues) 129. These Directors mainly work with the Family Advocates 119, i.e., the Family Advocate requests that the relevant Director observe a certain child to provide a diagnosis, who may then refer the child to a doctor, etc. For example, the Mental Health Director 125 may refer the child to a local psychologist to obtain a professional diagnosis. The Disabilities Director may refer a child to a local school system, which will then prepare an individual education plan (IEP) for the referred child.
II. Program Entry
A new grantee for HS needs to recruit preschool children, and may advertise, such as by using flyers, billboards, newspapers, events, etc., to get the word out. Low income families apply for admission by filling out an application form to determine whether they are eligible, i.e., income criteria (amount of income per family member) and age criteria (need to be 5 years old or younger).
The two stages related to entry into the program that are relevant are intake and enrollment, which are discussed below.
A. Intake
Intake begins by entering an application form. The goal of a typical HS agency is to serve 200-500 children.
At intake, the agency may receive a greater number of application forms than children that the agency can enroll; e.g., the agency may have 200 funded slots, but at intake the center may receive 300 application forms requesting enrollment. In this case, the application forms must typically be prioritized in order to determine which applications to accept, and this prioritization is accomplished using prioritization software, which uses a weighting system based on a pre-defined criteria, such as amount of income, age, etc. The prioritization software thereby ranks the children.
However, prioritization is not needed in some cases. For example, in extremely poor and isolated areas, such as at the Texas/Mexico border, everyone is such a good candidate (because of poverty, etc.) that applicants are admitted on a first-come first-served basis instead of using prioritization.
In some other cases, an agency's capacity may exceed the actual number of application forms received, e.g., the agency may have 200 funded slots, but may only receive 150 applications. In this case, the agency is allowed to enroll a certain percentage of kids who are above the poverty line. However, the families' income can never exceed 30% above the poverty line.
B. Enrollment
A number of federal rules become effective once a child is enrolled in HS, i.e., enrolled in a Classroom. These rules are in the form of 30 day, 45 day, and 90 day requirements, which are summarized as follows: 1) 30 day requirements—e.g., paperwork must be completed, confirmation of child's accessibility to medical insurance (typically Medicaid); 2) 45 day requirements—e.g., must complete child's sensory screening (vision and hearing); and 3) 90 day requirements—e.g., child must have a physical examination, which includes a referral needs to have been made to a doctor, the parents need to be informed that they need to take the child to a doctor for a physical examination, the medical examination needs to have been conducted, and the parents must provide HS with a copy of the completed examination form.
However, the HS center may attempt to exceed the above requirements (go above and beyond), such as by satisfying the 90 requirements within 45 days, satisfying the 45 requirements within 30 days, etc. If a center attempts to exceed the requirements in this manner, then the new rules apply to all applicants who are enrolled.
The health events are based on each state's recommended EPSDT (Early Periodic Screening, Diagnosis, and Treatment) schedule. However, many agencies use the American Academy of Pediatrics recommended EPSDT schedule in practice. This schedule provides a guideline for children to receive appropriate health screening, diagnosis and treatment based on age.